基于 CT 的放射组学特征与晚期实体瘤免疫检查点抑制剂治疗反应相关。
A CT-based Radiomics Signature Is Associated with Response to Immune Checkpoint Inhibitors in Advanced Solid Tumors.
机构信息
From the Radiomics Group, Vall d'Hebron Institute of Oncology (VHIO), Cellex Center, Natzaret 115-117, Barcelona 08035, Spain (M.L., A.G.R., R.P.L.); Oncology Data Science (ODysSey) Group, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain (C.V., G.V., R.D.); Institute of Radiology, Foundation IRCCS Polyclinic San Matteo, Pavia, Italy (M.V.R.); Department of Radiology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain (J.L.); Department of Medical Oncology, Vall d'Hebron University Hospital and Institute of Oncology (VHIO), Barcelona, Spain (I.M., J.M.L., M.O.d.O., C.H., J.M., M.G., R.M.B., C.S., J.R., E.E., I.B., E.M.C., A.O., E.F., J.T., J.C., E.G.); Department of Molecular Oncology, Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain (R.F., P.N.); Computer Vision Center, Department of Computer Science, Autonomous University of Barcelona, Cerdanyola del Vallès, Spain (D.G.); Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron University Hospital (HUVH), Autonomous University of Barcelona, Institució Catalana de Recerca i Estudis Avançats (ICREA) and CIBERONC, Barcelona, Spain (C.R.P., J.S.); Department of Radiology, Vall d'Hebron University Hospital, Barcelona, Spain (M.E., R.P.L.); and Department of Medicine, Autonomous University of Barcelona (UAB), Barcelona, Spain (J.T.).
出版信息
Radiology. 2021 Apr;299(1):109-119. doi: 10.1148/radiol.2021200928. Epub 2021 Jan 26.
Background Reliable predictive imaging markers of response to immune checkpoint inhibitors are needed. Purpose To develop and validate a pretreatment CT-based radiomics signature to predict response to immune checkpoint inhibitors in advanced solid tumors. Materials and Methods In this retrospective study, a radiomics signature was developed in patients with advanced solid tumors (including breast, cervix, gastrointestinal) treated with anti-programmed cell death-1 or programmed cell death ligand-1 monotherapy from August 2012 to May 2018 (cohort 1). This was tested in patients with bladder and lung cancer (cohorts 2 and 3). Radiomics variables were extracted from all metastases delineated at pretreatment CT and selected by using an elastic-net model. A regression model combined radiomics and clinical variables with response as the end point. Biologic validation of the radiomics score with RNA profiling of cytotoxic cells (cohort 4) was assessed with Mann-Whitney analysis. Results The radiomics signature was developed in 85 patients (cohort 1: mean age, 58 years ± 13 [standard deviation]; 43 men) and tested on 46 patients (cohort 2: mean age, 70 years ± 12; 37 men) and 47 patients (cohort 3: mean age, 64 years ± 11; 40 men). Biologic validation was performed in a further cohort of 20 patients (cohort 4: mean age, 60 years ± 13; 14 men). The radiomics signature was associated with clinical response to immune checkpoint inhibitors (area under the curve [AUC], 0.70; 95% CI: 0.64, 0.77; < .001). In cohorts 2 and 3, the AUC was 0.67 (95% CI: 0.58, 0.76) and 0.67 (95% CI: 0.56, 0.77; < .001), respectively. A radiomics-clinical signature (including baseline albumin level and lymphocyte count) improved on radiomics-only performance (AUC, 0.74 [95% CI: 0.63, 0.84; < .001]; Akaike information criterion, 107.00 and 109.90, respectively). Conclusion A pretreatment CT-based radiomics signature is associated with response to immune checkpoint inhibitors, likely reflecting the tumor immunophenotype. © RSNA, 2021 See also the editorial by Summers in this issue.
背景 需要可靠的预测免疫检查点抑制剂反应的影像学标志物。目的 开发并验证一种基于 CT 的放射组学特征，以预测晚期实体瘤患者对免疫检查点抑制剂的反应。材料与方法 在这项回顾性研究中，从 2012 年 8 月至 2018 年 5 月接受抗程序性细胞死亡 1 或程序性细胞死亡配体 1 单药治疗的晚期实体瘤（包括乳腺、宫颈、胃肠道）患者中建立了放射组学特征（队列 1）。然后在膀胱癌和肺癌患者（队列 2 和 3）中进行了验证。在预处理 CT 上勾画所有转移病灶，并通过弹性网络模型提取放射组学变量。使用包含反应作为终点的放射组学和临床变量的回归模型进行组合。使用 Mann-Whitney 分析评估细胞毒性细胞 RNA 谱的放射组学评分的生物学验证（队列 4）。结果 放射组学特征在 85 例患者中建立（队列 1：平均年龄 58 岁±13[标准差]；43 例男性），并在 46 例患者（队列 2：平均年龄 70 岁±12；37 例男性）和 47 例患者（队列 3：平均年龄 64 岁±11；40 例男性）中进行了验证。进一步在 20 例患者（队列 4：平均年龄 60 岁±13；14 例男性）中进行了生物学验证。放射组学特征与免疫检查点抑制剂的临床反应相关（曲线下面积[AUC]，0.70；95%CI：0.64，0.77；<0.001）。在队列 2 和 3 中，AUC 分别为 0.67（95%CI：0.58，0.76）和 0.67（95%CI：0.56，0.77；<0.001）。放射组学-临床特征（包括基线白蛋白水平和淋巴细胞计数）优于仅基于放射组学的表现（AUC，0.74[95%CI：0.63，0.84；<0.001]；Akaike 信息准则，107.00 和 109.90）。结论 基于 CT 的放射组学特征与免疫检查点抑制剂的反应相关，可能反映了肿瘤的免疫表型。©RSNA，2021 本期还刊登了 Summers 医生的相关述评。
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